Y4 Blackouts

Question 1

what two reflexes can result in syncope?

Answer 1

vagal over activity

sympathetic underactivity

Question 2

what could cause sympathetic under activity ?

Answer 2

Salt deficiency: hypovolaemia, Addison’s

􏰀 Toxins
􏰁 Cardiac: ACEi, diuretics, nitrates, α-B
􏰁 Neuro: TCAs, benzos, antipsychotics, L-
DOPA

􏰀 Autonomic Neuropathy: DM, Parkinson’s, GBS

􏰀 Dialysis

􏰀 Unwell: chronic bed-rest

􏰀 Pooling, venous: varicose veins, prolonged
standing

Question 3

what are the 5 causes of someone collapsing?

Answer 3

CRASH

cardiac
reflexes (vagal, sympathetic under activity)
arterial
systemic (↓glucose, hypoxia, hypercapnoea (e.g. anxiety), anaemia, hyper viscosity)
head (epilepsy)

Question 4

what are the causes of vertigo ? IMBALANCE

Answer 4

infection 
menieres
benign postural positional vertigo 
Aminoglycosides / frusemide
􏰀Lymph, Peri-, fistula
arterial 
nerve 
central lesions (demyelination, tumour, infarct) 
epilepsy

Question 5

what is Tullio’s phenoneum ?

Answer 5

nystagmus brought on by loud noise

Question 6

state some causes of hearing loss ? WIDENING

Answer 6

Wax or foreign body
􏰀 Infection: otitis media, OME
􏰀 Drum perforation
􏰀 Extra: ossicle discontinuity – otosclerosis, trauma 􏰀 Neoplasia: carcinoma
􏰀 INjury: e.g. barotrauma
􏰀 Granulomatous: Wegener’s, Sarcoid

Question 7

what is hearing loss in old age called?

Answer 7

Presbyacusis